Chapter 2 Inflammation and Repair Flashcards
1
Q
A collection of purulent exudate that has accumulated in a contained space formed by the surrounding tissue.
A
Abscess
2
Q
Relating to or exhibiting chemical changes produced by radiant energy, especially the visible and ultraviolet parts of the spectrum; relating to exposure to the ultraviolet rays of sunlight.
A
Actinic
3
Q
An injury or course of inflammation that is of short duration.
A
Acute
4
Q
The formation and differentiation of blood vessels.
A
Angiogenesis
5
Q
The programed cell death as part of an organism’s growth or development.
A
Apoptosis
6
Q
Abnormal decrease in the number of cells in an organ or tissue.
A
Atrophy
7
Q
Chemicals in the body that activate responses.
A
Biochemical mediators
8
Q
In the context of oral lesions, central indicates that the lesion is within the bone.
A
Central
9
Q
Causes of injury to orofacial tissue are?
A
Physical, chemical, infection, nutritional deficiency, and toxicity
10
Q
Can affect teeth, soft tissue, and bone
A
Physical injury
11
Q
Can occur from application of caustic substances
A
Chemical injury
12
Q
Microorganisms cause injury by invading orofacial tissues
A
Infection
13
Q
Render orofacial tissue more susceptible to injury from other sources
A
Nutritional deficiency
14
Q
Toxic overdoses of some nutrients can cause tissue damage
A
Toxicities
15
Q
Something we are born with, can be physical barriers or inflammation
A
Innate defenses
16
Q
Examples of physical barriers of innate defenses
A
Intact skin/mucosa, cilia/mucus in respiratory system, stomach acid in GI system, flushing action of tears, saliva, urine, and diarrhea, microbiota on skin preventing transient pathogens from colonizing, WBCs in inflammation going to site of injury
17
Q
Inflammation response is short, injury is minimal/brief, tissue returns to normal state by repair
A
Acute inflammation
18
Q
Injury is longer lasting, more extensive tissue damage and heals less readily, more functional deficiencies
A
Chronic inflammation
19
Q
Chronic inflammation can play a role in the pathogenesis of what?
A
Arthersclerosis, insulin resistance, Alzheimer’s disease, and cancer (these diseases exhibit high levels of CRP)
20
Q
CRP stands for?
A
C-reactive protein a proinflammatory marker in the blood
21
Q
What are considered the local major clinical cardinal signs of inflammation?
A
Redness, heat, swelling, pain, loss of normal level of tissue function
22
Q
Systemic clinical signs of inflammation are?
A
Fever, leukocytosis, lymphadenopathy, elevated CRP
23
Q
Microscopic events of inflammation involve?
A
Small blood vessels, RBCs, WBCs, chemicals called biochemical mediators
24
Q
Exchange of oxygen – plasma fluid passes between the endothelium and vessel walls
A
Microcirculation
25
Plasma contains?
Fluid component of the blood, suspension of blood cells
26
The lymphatic vessels do what?
Carry away excess plasma in microcirculation
27
Steps in microscopic events of inflammation are?
1. Brief reflex constriction of microcirculation in area of injury
2. Dilation of the same vessels (increased diameter caused by biochemical mediators)
3. Increased blood flow results in hyperemia then erythema and heat
4. Permeability of microcirculation leads to exudate formation
5. Loss of plasma increases viscosity of blood
6. RBCs pile in center of vessels
7. Margination (WBCs move periphery of blood vessels)
8. Pavementing (WBCs adhere to inner walls of injured vessels)
9. Emigration (WBCs escape from blood vessel to tissue)
10. Emigration increases permeability of microcirculation, exudate
11. Presence of transudate and exudate trigger immune response
12. As fluid escapes it collects in fibrous connective tissue leading to edema/swelling
13. Further injury can lead to clear serous exudate
14. May also flow as thick yellow/white pus or purulent exudate
28
Undifferentiated multipotent cells, produced in spongy tissue of the bone marrow, WBCs are derived from this
Hemopoietic stem cells (HBC)
29
The two types of cells involved initially in inflammation are?
Neutrophils, monocytes
30
First to arrive, most common inflammatory cell involved in acute inflammation
Neutrophil
31
Second to arrive, becomes a macrophage when it enters surrounding tissue
Monocyte
32
Macrophages, lymphocytes, and plasma cells replace neutrophils
WBCs in chronic inflammation
33
60-70% of entire WBC population, main function is phagocytosis of pathogenic microorganisms and tissue debris
Neutrophil
34
3-8% of WBC population
monocyte/macrophage
35
The two types of macrophages are?
M1 and M2
36
Encourage inflammation, metabolize arginine to the "killer" molecule nitric oxide
M1 macrophage
37
Encourage repair, metabolize arginine to the "repair" molecule ornithine
M2 macrophage
38
The three major systems of plasma proteins are?
Kinin system, clotting mechanism, complement system
39
Causes increased dilation and permeability of blood vessels, activated by substances present in plasma/injured tissue, role in early inflammation
Kinin system
40
Primary kinin is?
bradykinin
41
Rapidly degrades to kininases present in plasma/tissue normally
bradykinin
42
Can cause local vascular dilation and permeability by activating the kinin system, forms fibrous meshwork at the site of injury
Clotting mechanisms
43
Functions during inflammation and immunity, can cause mast cells to release granules from their cytoplasms containing histamine, involved in cytolysis and opsonization
Complement system
44
Single, membrane-spanning, noncatalytic receptors usually expressed on macrophages and dendritic cells
Toll-like receptors
45
Intracellular sensors of PAMPs that enter the cell via phagocytosis, pores, and DAMPs that are associated with cell stress
Nodlike receptors
46
The movement of white blood cells, as directed by biochemical mediators, to an area of injury.
Chemotaxis
47
An injury or course of inflammation that is of long duration.
Chronic
48
A nonspecific protein, produced in the liver, that becomes elevated during episodes of acute inflammation or infection.
C-reactive protein
49
Indentations or grooves, as seen on the side of the tongue, caused by irritation from adjacent teeth.
Crenation
50
An abnormal sac or cavity lined by epithelium and surrounded by fibrous connective tissue.
Cyst
51
When tooth wear is increased by chewing on an abrasive substance.
Demastication
52
An excess level of plasma or exudate in the interstitial space that results in tissue swelling.
Edema
53
The passage of white blood cells through the walls of small blood vessels and into injured tissue.
Emigration
54
The process of renewal of a new surface layer of epithelium.
Epithelialization
55
The redness of the skin or mucosa.
Erythema
56
A body fluid with a high protein content that leaves the microcirculation during an inflammatory response that consists of serum that contains white blood cells, fibrin, and other protein molecules.
Exudate
57
An elevation of body temperature to greater than the normal level of 37 degrees C (98.6 F).
Fever
58
The cells that form fibers as well as intercellular substance.
Fibroblasts
59
The formation of fibrous tissue as usually occurs in healing.
Fibroplasia
60
The formation of excess fibrous connective tissue in an organ or tissue.
Fibrosis
61
An abnormal passage that leads from an abscess to an outside body surface.
Fistula
62
The initial connective tissue formed in healing.
Granulation tissue
63
A tumorlike mass of inflammatory tissue consisting of a central collection of macrophages, often including multinucleated giant cells, surrounded by lymphocytes.
Granuloma
64
An excess of blood within blood vessels in a part of the body.
Hyperemia
65
An enlargement of a tissue or organ resulting from an increase in the number of cells; the result of increased cell division.
Hyperplasia
66
An enlargement of a tissue or organ resulting from and increase in the size of its individual cells but not in the number of cells.
Hypertrophy
67
A nonspecific response to injury that involves the microcirculation and its blood cells.
Inflammation
68
An alteration in the environment or trauma that causes tissue damage.
Injury
69
Excessive scarring that mainly occurs in skin in some cases with healing.
Keloid
70
An increase in the number of white blood cells circulating in blood.
Leukocytosis
71
A decrease in the number of white blood cells circulating in blood.
Leukopenia
72
A disease process that is confined to a limited location in the body that is not general or systemic.
Local
73
The abnormal enlargement of a lymph node or nodes.
Lymphadenopathy
74
The second type of white blood cell to arrive at a site of injury that was originally a monocyte; it participates in phagocytosis during inflammation and continues to be active in the immune response.
Macrophage
75
A process during inflammation in which white blood cells tend to move to the periphery of the blood vessel at the site of injury.
Margination
76
The small blood vessels, including arterioles, capillaries, and venules of the vascular system.
Microcirculation
77
Fibroblasts that have some of the characteristics of smooth muscle cells, such as the ability to contract.
Myofibroblasts
78
The pathologic death of one or more cells, or a part of tissue, or an organ that results from irreversible damage to cells.
Necrosis
79
The first white blood cell to arrive at a site of injury; the primary cell involved in acute inflammation; also called a polymorphonuclear leukocyte (PMN).
Neutrophil
80
Intracellular sensors of pathogen-associated molecular patterns of molecules (PAMPs) that enter the cell via phagocytosis or pores and danger-associated molecular patterns (DAMPs) that are associated with cell stress.
Nod-like receptors NLR
81
The process of becoming opaque.
Opacification
82
The enhancement of phagocytosis by a process in which a pathogen is marked with opsonins, for destruction by phagocytes.
Opsonization
83
The cell that forms bone.
Osteoblast
84
A collection of granulation tissue and abscessed material on the gingiva, which originates from a chronically inflamed tooth and spreads via a fistulous track. Also known as a gum boil.
Parulis
85
The adherence of white blood cells to blood vessel walls during inflammation.
Pavementing
86
Dental erosion caused by gastric acid.
Perimolysis
87
In the context of oral lesions, a term that indicates that the lesion is within the gingival tissue or alveolar mucosa and outside the bone.
Peripheral
88
The ingestion and digestion of particulate material by cells.
Phagocytosis
89
An exudate containing or forming pus.
Purulent exudate
90
The fever-inducing substances produced from either white blood cells or pathogenic microorganisms.
Pyrogens
91
Pertaining to the root of a tooth.
Radicular
92
The process by which injured tissue is replaced with tissue identical to that present before the injury.
Regeneration
93
The restoration of damaged or diseased tissue by cellular change and growth.
Repair
94
An exudate that has a watery consistency that resemble serum.
Serous exudate
95
These endogenous autocoids are cell-signaling biologic factors that are similar to hormones and serve to actively promote resolution of inflammation.
Specialized proresolving lipid mediators (SPMs)
96
Pertaining to or affecting the body, as well as a disease pertaining to or affecting the body as a whole.
Systemic
97
Involvement of the sublingual space/floor of the mouth area by a plunging ranula, as seen on three-dimensional imaging studies.
Tail sign
98
The receptors usually expressed on cells such as macrophages and dendritic cells that recognize structurally conserved molecules derived from microbes.
Toll-like receptors (TLRs)
99
The extravascular fluid component of blood that passes through the endothelial cell walls of the microcirculation.
Transudate
100
A disease process that results from injury that causes tissue damage.
Traumatic injury
101
The ring of lymphatic tissue formed by the two palatine tonsils, the pharyngeal tonsil, the lingual tonsil, and intervening lymphoid tissue.
Waldeyer ring
102
The cells within the blood and surrounding tissue that are involved in the inflammatory and immune responses: also called leukocytes.
WBCs
103
Considered to be a physiologic process; it is the wearing away of tooth structures during tooth-to-tooth contact or mastication.
Attrition
104
The grinding of the teeth together from nonfunctional purposes.
Bruxism
105
The pathologic wearing of tooth structure or a restoration that results from a mechanical habit.
Abrasion
106
Typically appears as a wedge-shaped defect at the cervical area of teeth, especially premolars. The cause is related to microfracture of tooth structure in areas of concentration of stress.
Abfraction
107
The irreversible loss of tooth structure resulting form chemical action without bacterial involvement.
Erosion
108
An eating disorder characterized by food binges, usually very high caloric intake, followed by self-induced vomiting.
Bulimia nervosa
109
An eating disorder characterized by intense fear of gaining weight and self-imposed starvation.
Anorexia nervosa
110
Results from the intake of methamphetamine. Methamphetamine has a high acid content and causes people to brux, have extreme xerostomia, crave high sugar-containing beverages and combined with poor oral hygiene results in extensive and rapid destruction of teeth.
Meth mouth
111
Generally occurs when a patient has a toothache and places an aspirin tablet or powder directly on the painful tooth and adjacent mucosal tissue.
Aspirin burn
112
Considered reactive lesions and occur as the result of some form of trauma.
Traumatic ulcers
113
Caused by persistent trauma and results in a raised lesion.
Traumatic granuloma
114
A lesion that results from the accumulation of blood within tissue as a result of trauma.
Hematoma
115
White lesions that are not caused by trauma and arise spontaneously, sometimes referred to as idiopathic leukoplakia.
Leukoplakia
116
A white raised lesion that forms most commonly on the buccal mucosa at the occlusal plane.
Linea alba
117
Indentions or grooves in the side of the tongue, often seen with bruxism.
Crenated tongue
118
A benign lesion on the hard palate most typically associated with heavy, long-term pipe or cigar smoking.
Nicotine stomatitis
119
A white lesion which occurs where patient's place their tobacco.
Smokeless tobacco keratosis or tobacco pouch keratosis
120
A microscopic diagnosis that indicates disordered growth and is considered a premalignant condition.
epithelial dysplasia
121
A reactive lesion caused by injury to a peripheral nerve.
Traumatic neuroma
122
A benign lesion that has microscopic features similar to those of a traumatic neuroma.
Palisaded encapsulated neuroma (PEN) - or solitary circumscribed neuroma
123
A flat, bluish-gray lesion of the oral mucosa that results form the introduction of amalgam into oral tissue.
Amalgam tattoo
124
Melanin pigmentation that occurs after an inflammatory response.
Post inflammatory melanosis
125
A flat, well-circumscribed brown lesion of unknown cause.
Oral melanotic macule
126
Lower lip vermillion border is the most common site, characteristically darkens when exposed to sunlight.
Labial melanotic macule
127
Melanin pigmentation that is resultant from smoking, the intensity of the melanosis is related to the duration of the smoking habit.
Smoker's melanosis or smoking-associated melanosis
128
Degeneration of the tissue of the vermillion of the lips from sun exposure.
Solar or actinic cheilitis
129
A lesion that forms when a salivary gland duct is severed or ruptured and the mucous salivary secretion spills into the adjacent connective tissue.
Mucocele
130
An epithelium-lined cystic structure occurs in association with a salivary gland duct.
Mucous cyst
131
Term used for larger mucocele-like lesion that forms on the floor of the mouth.
Ranula
132
A ranula that extends through the mylohyoid muscle and presents with a fluctuant neck swelling.
Plunging ranula
133
A salivary gland stone.
Sialolith
134
A local, painful, benign condition of the salivary glands characterized by moderately painful swelling followed by ulceration in the affected area.
Necrotizing Sialometaplasia
135
Inflammation of salivary gland tissue.
Sialadenitis
136
Consists of proliferating, exuberant granulation tissue and hyperplastic fibrous connective tissue, lesion results from overzealous repair.
Reactive connective tissue hyperplasia
137
A benign, reactive, commonly occurring intraoral lesion that is characterized by a proliferation of connective tissue containing numerous blood vessels and inflammatory cells that resembles granulation tissue.
Pyogenic granuloma
138
Pyogenic granuloma which occur in pregnant women, may be due to hormonal changes or an increased response to oral biofilm.
Pregnancy tumors or granuloma gravidarum
139
A reactive lesion that is composed of well-vascularized connective tissue with multi-nucleated giant cells.
Giant Cell Granuloma
140
Occur on the gingiva or alveolar process, usually anterior to the molars, considered a reactive lesion due to irritating factors such as dental biofilm or calculus.
Peripheral giant cell granuloma
141
Is a broad-based, persistent exophytic lesion composed of dense, scar like connective tissue containing few blood vessels, occurs as a result of chronic or an episode of trauma.
Irritation fibroma or traumatic fibroma or focal fibrous hyperplasia
142
A small fingerlike projection of hyperplastic fibrous tissue attached to the maxillary labial frenum.
Frenal tag
143
Is a form of denture-induced hyperplasia, the vault of the palate is covered by multiple erythematous papillary projections that give the area a granular or "cobblestone" appearance.
Papillary Hyperplasia of the palate or palatal papillomatosis
144
Enlargement of the gingiva.
Gingival Hyperplasia
145
An excessive proliferation of chronically inflamed dental pulp tissue.
Chronic hyperplastic pulpitis or pulp polyp
146
Composed of a purulent exudate surrounded by connective tissue containing neutrophils and lymphocytes located at the apex of a non-vital tooth.
Periapical abscess
147
A rare, severe consequence of dental infection that results in a rapidly aggressive form of cellulitis, may obstruct the airway and be life threatening.
Ludwig angina
148
A localized mass of chronically inflamed granulation tissue that forms at the opening of the pulp canal, generally at the apex of a nonvital tooth root.
Periapical granuloma, dental granuloma or chronic apical periodontitis
149
A true cyst located at the apex of the root of a nonvital tooth.
Periapical cyst
150
A cyst that results when a tooth is removed and all or part of a periapical cyst is left behind.
Residual cyst
151
"Dense bone island" not associated with inflammation, can appear radiographically similar to sclerosing osteomyelitis.
Idiopathic osteosclerosis
152
A postoperative complication of tooth extraction, due to the blood clot being lost from the extraction site.
Alveolar osteitis or "dry socket"
